Nokea
A client with chronic obstructive pulmonary disease (COPD) is admitted to the respiratory unit. Which physician prescription should the nurse question?
- A. Oâ‚‚ at 5 L/min by nasal cannula
- B. Solu Medrol 125 mg IV push every 6 hours
- C. Ceftriaxone (Rocephin) 1gram IVPB daily
- D. Darvocet N 100 po prn pain
Correct Answer: A
Rationale: High-flow oxygen (5 L/min) can suppress the hypoxic drive in COPD clients, risking CO2 retention. Low-flow oxygen (1-2 L/min) is safer and should be questioned.
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A 23-year-old woman who is 16 weeks pregnant is seen by the nurse for a routine maternal-child clinic appointment. The client has had erratically controlled type 1 diabetes since 12 years old. The client asks the nurse if she is at risk during her pregnancy. The nurse instructs the client she should do which of the following actions to limit complications for both her and her baby? Select all that apply.
- A. eat healthy foods
- B. refrain from exercise
- C. take medications as directed
- D. monitor her blood sugar before every meal
Correct Answer: A, C, D
Rationale: Healthy eating, taking insulin as directed, and monitoring blood sugar before meals help control diabetes and reduce pregnancy complications. Exercise is generally encouraged, not avoided.
The client with a myocardial infarction comes to the nurse's station stating that he is ready to go home because there is nothing wrong with him. Which defense mechanism is the client using?
- A. Rationalization
- B. Denial
- C. Projection
- D. Conversion reaction
Correct Answer: B
Rationale: Denial involves refusing to acknowledge a serious condition.
The nurse enters the client's room and smells cigarette smoke. When confronted, the client says, 'I only smoked one cigarette because I was having a bad craving.' Which action by the nurse is most appropriate?
- A. escort the client outside to smoke
- B. call the health care provider to obtain an order for a nicotine patch
- C. remind the client that oxygen is in use and smoking is banned in the facility
- D. tell the client that if he continues to smoke in the room, he will be discharged from the hospital
Correct Answer: C
Rationale: Reminding the client of the danger of smoking near oxygen and hospital policy addresses safety and compliance immediately.
The nurse is caring for a client admitted with acute laryngotracheobronchitis (LTB). Because of the possibility of complete obstruction of the airway, which of the following should the nurse have available?
- A. Intravenous access supplies
- B. Emergency intubation equipment
- C. Intravenous fluid-administration pump
- D. Supplemental oxygen
Correct Answer: B
Rationale: Emergency intubation equipment is essential for LTB due to the risk of airway obstruction requiring immediate intervention.
Heparin has been ordered for a client with pulmonary embolis. Which statement, if made by the graduate nurse, indicates a lack of understanding of the medication?
- A. I will administer the medication 1-2 inches away from the umbilicus.'
- B. I will administer the medication in the abdomen.'
- C. I will check the PTT before administering the medication.'
- D. I will need to aspirate when I give Heparin.'
Correct Answer: D
Rationale: Aspirating during heparin injection is incorrect, as it increases the risk of hematoma formation in subcutaneous administration.